Treatment of Coronary Artery Disease and Acute Myocardial Infarction in Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery

Edward L. Hannan, Ye Zhong, Yifeng Wu, Peter B. Berger, Alice K. Jacobs, Gary D Walford, Ferdinand J. Venditti, Frederick S.K. Ling, Jacqueline Tamis-Holland, Spencer B. King

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Many studies have revealed no outcome differences among patients undergoing percutaneous coronary intervention (PCI) in hospitals with and without surgery on-site (SOS), but one earlier study found differences in target vessel PCI rates and in mortality for patients with acute myocardial infarction who did not undergo PCI. It is important to examine outcome differences between SOS and non-SOS hospitals with more contemporary data. METHODS AND RESULTS: A total of 21 924 propensity-matched patients who were discharged between January 1, 2013, and November 30, 2015, who were in the New York PCI registry and other hospital databases were used to compare outcomes in hospitals with and without SOS for all patients and for patients with and without ST-segment-elevation myocardial infarction (STEMI) undergoing PCI. Also, 30-day mortality was compared for patients with STEMI regardless of whether they underwent PCI. For all patients with PCI and patients without STEMI, there were no significant differences in in-hospital/30-day mortality, 2-year mortality, or 2-year repeat target lesion PCI. For patients with STEMI, there were no significant mortality differences between patients in SOS and non-SOS hospitals. Patients with STEMI in SOS hospitals had significantly lower 2-year repeat target lesion PCI rates (adjusted hazard ratio, 0.68 [0.49-0.94]). There was no difference in the percentage of patients undergoing PCI in the 2 types of hospitals (75.7% versus 74.6%; P=0.21) or in 30-day mortality of all patients with STEMI (patients who did and did not undergo PCI, 10.86% versus 11.32%; adjusted odds ratio, 1.06 [0.88-1.29]). CONCLUSIONS: Short-term and long-term outcomes were not different in SOS and non-SOS hospitals except that 2-year repeat target lesion PCI rates were lower in SOS hospitals for patients with STEMI.

Original languageEnglish (US)
Pages (from-to)e007097
JournalCirculation. Cardiovascular interventions
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2019

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Coronary Artery Bypass
Coronary Artery Disease
Percutaneous Coronary Intervention
Myocardial Infarction
Transplants
Therapeutics
Mortality
Registries
Odds Ratio

Keywords

  • coronary artery disease
  • humans
  • New York
  • percutaneous coronary intervention
  • ST-elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Treatment of Coronary Artery Disease and Acute Myocardial Infarction in Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery. / Hannan, Edward L.; Zhong, Ye; Wu, Yifeng; Berger, Peter B.; Jacobs, Alice K.; Walford, Gary D; Venditti, Ferdinand J.; Ling, Frederick S.K.; Tamis-Holland, Jacqueline; King, Spencer B.

In: Circulation. Cardiovascular interventions, Vol. 12, No. 1, 01.01.2019, p. e007097.

Research output: Contribution to journalArticle

Hannan, Edward L. ; Zhong, Ye ; Wu, Yifeng ; Berger, Peter B. ; Jacobs, Alice K. ; Walford, Gary D ; Venditti, Ferdinand J. ; Ling, Frederick S.K. ; Tamis-Holland, Jacqueline ; King, Spencer B. / Treatment of Coronary Artery Disease and Acute Myocardial Infarction in Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery. In: Circulation. Cardiovascular interventions. 2019 ; Vol. 12, No. 1. pp. e007097.
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abstract = "BACKGROUND: Many studies have revealed no outcome differences among patients undergoing percutaneous coronary intervention (PCI) in hospitals with and without surgery on-site (SOS), but one earlier study found differences in target vessel PCI rates and in mortality for patients with acute myocardial infarction who did not undergo PCI. It is important to examine outcome differences between SOS and non-SOS hospitals with more contemporary data. METHODS AND RESULTS: A total of 21 924 propensity-matched patients who were discharged between January 1, 2013, and November 30, 2015, who were in the New York PCI registry and other hospital databases were used to compare outcomes in hospitals with and without SOS for all patients and for patients with and without ST-segment-elevation myocardial infarction (STEMI) undergoing PCI. Also, 30-day mortality was compared for patients with STEMI regardless of whether they underwent PCI. For all patients with PCI and patients without STEMI, there were no significant differences in in-hospital/30-day mortality, 2-year mortality, or 2-year repeat target lesion PCI. For patients with STEMI, there were no significant mortality differences between patients in SOS and non-SOS hospitals. Patients with STEMI in SOS hospitals had significantly lower 2-year repeat target lesion PCI rates (adjusted hazard ratio, 0.68 [0.49-0.94]). There was no difference in the percentage of patients undergoing PCI in the 2 types of hospitals (75.7{\%} versus 74.6{\%}; P=0.21) or in 30-day mortality of all patients with STEMI (patients who did and did not undergo PCI, 10.86{\%} versus 11.32{\%}; adjusted odds ratio, 1.06 [0.88-1.29]). CONCLUSIONS: Short-term and long-term outcomes were not different in SOS and non-SOS hospitals except that 2-year repeat target lesion PCI rates were lower in SOS hospitals for patients with STEMI.",
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